b is a moderate CYP3A4 inhibitor and cariprazine is a CYP3A4 substrate.
Ceritinib: (Major) Avoid coadministration of ceritinib with ribociclib due to increased ribociclib exposure and the risk of QT prolongation. If coadministration cannot be avoided, periodically monitor electrolytes and ECGs; an interruption of ceritinib therapy, dose reduction, or discontinuation of therapy may be necessary if QT prolongation occurs. Ceritinib is a CYP3A4 inhibitor that causes concentration-dependent prolongation of the QT interval. Ribociclib is primarily metabolized by CYP3A4 and is also associated with concentration-dependent QT prolongation; these ECG changes generally occurred within the first four weeks of treatment and were reversible with dose interruption.
Cevimeline: (Moderate) Use caution if coadministration of ribociclib, a moderate CYP3A4 inhibitor, with cevimeline, a CYP3A4 substrate, is necessary, as the systemic exposure of cevimeline may be increased resulting in an increase in cevimeline-related adverse reactions.
Chloramphenicol: (Major) Avoid coadministration of ribociclib with chloramphenicol, as the systemic exposure of ribociclib may be increased resulting in an increase in ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation); consider an alternative treatment with less potential for CYP3A inhibition. If concomitant use is unavoidable, reduce the dose of ribociclib to 400 mg once daily; if chloramphenicol is discontinued, the original dose of ribociclib may be resumed after at least 5 half-lives of chloramphenicol. Ribociclib is extensively metabolized by CYP3A4 and chloramphenicol is a strong CYP3A4 inhibitor.
Chlordiazepoxide: (Moderate) Use caution if coadministration of ribociclib with chlordiazepoxide is necessary, as the systemic exposure of chlordiazepoxide may be increased resulting in increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of chlordiazepoxide if necessary. Ribociclib is a moderate CYP3A4 inhibitor and chlordiazepoxide is a CYP3A4 substrate.
Chlordiazepoxide; Clidinium: (Moderate) Use caution if coadministration of ribociclib with chlordiazepoxide is necessary, as the systemic exposure of chlordiazepoxide may be increased resulting in increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of chlordiazepoxide if necessary. Ribociclib is a moderate CYP3A4 inhibitor and chlordiazepoxide is a CYP3A4 substrate.
Chloroquine: (Major) Ribociclib should be avoided in patients receiving medications known to prolong the QT interval, such as chloroquine. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. These ECG changes occurred within the first four weeks of treatment and were reversible with dose interruption. Chloroquine is associated with an increased risk of QT prolongation and torsade de pointes (TdP); fatalities have been reported. The risk of QT prolongation is increased with higher chloroquine doses.
Chlorpheniramine; Codeine: (Moderate) Use caution if coadministration of ribociclib with codeine is necessary, as the systemic exposure of codeine may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of codeine if necessary. Ribociclib is a moderate CYP3A4 inhibitor. Codeine is primarily metabolized |
